Most-prescriped Medications Typical medications(D2 receptor antagonists) Low potency agents-Chlorpromazine(sedation) High potency agents- Haloperidol(motor problems extrapyramidal effects) Good ability to treat hallucinations and delusions in most people within approximately 2 months Limited effect on negative symptoms
Most-prescriped Medications • Typical medications (D2 receptor antagonists) – Low potency agents - Chlorpromazine (sedation) – High potency agents - Haloperidol (motor problems – extrapyramidal effects) – Good ability to treat hallucinations and delusions in most people within approximately 2 months – Limited effect on negative symptoms 11
Dopaminergic pathways in the CNS and pharmacological effects of D2 antagonists A. mesolimbic and mesocortical pathways: related to psychological activities and the therapeutic effects of drugs B nigrostriatal pathway related to extrapyramidal adverse effects of drugs C. Tuberohypophyseal pathway related to hypothalamus endocrine adverse effects of drugs 12
Dopaminergic pathways in the CNS and pharmacological effects of D2 antagonists A. mesolimbic and mesocortical pathways: related to psychological activities and the therapeutic effects of drugs. B. nigrostriatal pathway related to extrapyramidal adverse effects of drugs C. Tuberohypophyseal pathway related to hypothalamus endocrine adverse effects of drugs 12
Most-prescriped Medications Typical medications(D2 receptor antagonists) Aty pical agents Clozapine-D1, D2, 5-HT2 and Da antagonist, great efficacy Olanzapine -5-HT2, D1, D2, M, H, a antagonist, good Risperidone -5-HT2 and d2 antagonist, good Aripiprazole -partial agonist of D2 and 5-HT1, good 13
Most-prescriped Medications • Typical medications (D2 receptor antagonists) • Atypical agents – Clozapine – D1, D2, 5-HT2 and D4 antagonist, great efficacy – Olanzapine – 5-HT2 , D1, D2, M, H, α antagonist, good – Risperidone – 5-HT2 and D2 antagonist, good – Aripiprazole – partial agonist of D2 and 5-HT1 , good 13
Chlorpromazine 1. Pharmacological effects (1)Central effects a) Antipsychotic effects(neuroleptic effects) controls excitation and then hallucinations (slow, weeks to months) b)Antiemetic effect inhibits chemoreceptor trigger zone(ctz in the medulla 14
a) Antipsychotic effects (neuroleptic effects) -- controls excitation and then hallucinations (slow, weeks to months) b) Antiemetic effect -- inhibits chemoreceptor trigger zone (CTZ) in the medulla Chlorpromazine 1. Pharmacological effects (1) Central effects 14
Chlorpromazine c)Poikilothermic effects(comparison with NSAIDs) hypothermic anesthesia artificial hibernation(with meperidine, promethazine) d) Extrapyramidal effects(nigrostriatal pathway blockade primary adverse effects e) Potentiating the effects of central depressants sedative-hypnotICS, analgesICs, general anesthetIcS ethanol 15
c) Poikilothermic effects (comparison with NSAIDs) -- hypothermic anesthesia -- artificial hibernation (with meperidine, promethazine) d) Extrapyramidal effects (nigrostriatal pathway blockade) -- primary adverse effects e) Potentiating the effects of central depressants -- sedative-hypnotics, analgesics, general anesthetics, ethanol Chlorpromazine 15